In his opening interview remarks, Mr. Jarvis Hoult, the Executive Director
of Hamad General Hospital, high-lighted, that as the sole tertiary referral
hospital in Qatar, the organization is currently witnessing a number of
developments in the Emergency Department; Outpatients Department; and
Inpatient wards, which will improve the quality of services to HGH patients.
In 2006, Hamad General Hospital treated 410,831 outpatients (+19% more than
1996) and 395,226 ER patients (+220% more than 1996). Over the past 10
years, the number of patient admissions has averaged around 25,500 per year
(even with bed reductions from the original 640 beds when the hospital first
opened).
The Health Magazine made this interview with Mr. Hoult in the presence of
Mr. Nagi Al Mannai, Assistant Executive Director, Support Services, who
participated in highlighting details of current and future projects of the
hospital.
Mr. Hoult pointed out that a revised process of patient registration and
triage in the Emergency Department has resulted in a 30% fall in the
numbers of Department’s visitors. An automated Patient Booking and
Appointment System will be introduced at Outpatient Department and will
reduce waiting times and improved OPD clinic utilization.
As regards the problem of bed shortage at the hospital, Mr. Hoult unveiled a
number of decisive steps to overcome this problem. Such remedies include
adding extra 35 beds to the current hospital capacity of 599 beds, upon the
transformation of current doctor offices into inpatient rooms. An additional
60 beds will be available when the new Specialized Cardiology Centre becomes
operational. Furthermore, the implementation and expansion of the Home
Care Program has the potential to free up to 100 additional beds currently
occupied by Long-Term Care patients, for the admission of acute cases.
In response to the question regar-ding developments witnessed by the Hamad
General Hospital during the past two years with medical facilities and
treatment programs, Mr. Hoult stated that the Hamad General Hospital has
seen the introduction of many new programs and medical services. Some of
these new programs and services have been driven by the introduction of new
technologies; and, some of our new medical services are expansions of
existing services offered by the Hospital. He listed some of the newly
introduced services/technologies:
New cardiac procedures intro-duced in the Cardiac Catheterization
Laboratory.
New long-term [30-day] cardiology monitoring equipment offered
to
outpatients in the Clinics.
The dialysis program (which is a national program offered by
Hamad General
Hospital) has significantly expanded the
availability of its services. A
new facility is almost finished in Al
Khor.
The Neurophysiology Laboratory is currently under construction
and
renovation to provide better services.
The Department of Pediatrics has introduced a Pediatric
Pulmonary Function
Laboratory that is growing and expanding
each year.
The expansion of the facilities at the Al Saad Pediatric Emergency
Center is
almost complete.
Mr. Hoult commented that the Hamad General Hospital Emergency Department
Extension is almost complete and will be commissioned shortly (within a
period of 1 or two months). This extension will increase the size of the
current department by almost 50%. The introduction of the New Triage Policy
has significantly reduced the number of non-emergent patients, thereby
allowing the Department to improve services through reduced waiting times
and a faster turnaround on the delivery of patient care. The New Triage
Policy has resulted in a 30% reduction in the number of ED visitors (from
1300 – 1350 before to 700 – 800 currently). Furthermore, many benefits have
been realized with the HMC/UPMC Partnership (University of Pittsburgh
Medical Center (UPMC). UPMC is providing technical and professional
consultation on an ongoing basis to enhance HMC’s Accident and Emergency
Services.
Mr. Hoult also noted that the Department of Radiology has upgraded and
replaced two CT Scanners, and one MRI unit. This year the Department
launched a project to acquire and install Picture Archiving and Capture
System (|PACS) that will be introduced in Hamad General Hospital; and, then
expanded to all the Hamad Medical Corporation hospitals.
In closing his remarks on this subject, Mr. Hoult emphasized that the above
achievements represent only a small highlight of new and/or expanded
programs at Hamad General Hospital. The workload at Hamad General Hospital
over the past two years has significantly increased. The pressure placed
upon the facilities and structure of Hamad General Hospital as the result of
the influx of people into Qatar has been significant. The response of our
staff in the face of this workload cannot go unnoticed ... it represents an
impressive achievement and accom-plishment on the part of everyone working
at the Hospital.
On the subject of the benefits to the patients as the result of Hamad
General Hospital being accredited by the Joint Commission International, Mr.
Hoult stated that the best way to describe this “benefit” of JCIA
accreditation is to say “that Hamad General Hospital has achieved the
ability to provide better care… in a better way”. He went on to say that It
is important to note that hospitals can only do better if they constantly
set standards of care and practice that are always [a little] higher than
the year before. The ability to achieve improved quality of care requires
tools, benchmarked targets, policies and procedures; compliance with
international standards of practice; and as well, a great deal of individual
commitment on the part of the Hospital staff. But we cannot do it with just
commitment alone … and JCIA has given us the tools and standards to better
manage and monitor the care we provide to the people of Qatar.
In response to the question that there are ongoing concerns such as lack of
parking; waiting for appointments; waiting times in the OPD; waiting to get
a bed for admission; etc., Mr. Hoult answered that these are legitimate
comments that the Hamad General Hospital must address. However, Mr. Hoult
went on to state that these are not issues that are addressed or fixed by
being JCIA accredited. JCIA has resulted in the improvement and the quality
of patient care … and while this is a most significant factor … the quality
of care that our patients receive is only one part of the overall
“experience” that patients receive when they come to the Hospital. As a
hospital, we must work to improve the Total Experience of our patients and
their families. The best quality patient treatment and care provided in a
total experience of long waiting lines; crowded waiting rooms; and, no place
to park your care . . . is not acceptable.
With respect to the fact that Hamad General Hospital is the only tertiary
referral hospital in Qatar, Mr. Hoult stated that the future for Hamad
General Hospital will continue to present us with many challenges and
pressures. The commissioning of the Hamad Medical City is still 3-to-5 years
away. The Sidra Hospital (sponsored by Qatar Foundation) has yet to begin
construction. Hamad General Hospital has both the challenge... and
responsibility ... of being the only tertiary referral hospital for Qatar.
The population of Qatar will continue to grow . . . patient workload will
continue to grow. The ability of Hamad General Hospital to physically expand
in the face of this growth is all but impossible. Mr. Hoult indicated that
one of the key strategies we are focusing on, as an organization, is to
maximize the utilization of our existing resources and manpower. The focus
of the goals and objectives for Hamad General Hospital in 2007/8 and 2008/9
are centred on resource utilization. There are many initiatives and
processes that we, as a hospital, can put into place to better utilize the
resources available. The management of change will be crucial if we are to
succeed.
When asked about those areas of Hamad General Hospital that will still need
his intensive support, Mr. Hoult replied that there will continue to be the
priority to constantly strive to improve what we do and how we do it. I
see one of my primary roles, as Executive Director is to challenge the
organization to use the JCIA tools and standards every day. Hospitals can
never say that what they are doing is “Good enough”… and then stop trying to
improve. The reality is that when it comes to caring for patients … in many
instances “good enough... is never good enough.”
Mr. Hoult went on to add, that Hamad General Hospital is working to
introduce the concept of a “shared governance” model in the hospital. What
this means is, that as Executive Director, I believe that the decisions that
we make should be the result of consultation and input from the medical
staff leadership; the senior management staff; and, our hospital staff. The
combined ‘energies and knowledge’ of this partnership can only lead to
better and faster decisions.
Mr. Hoult added that one of the key strategies that he will be pushing is
the introduction of more information technology systems at Hamad General
Hospital. Our most valuable resource is our staff. The acquisition of
information technology systems is one way to improve the efficiency and
effectiveness of our people. New systems will improve our ability to better
respond to the needs of patients and our customers. We will be working very
hard to improve the Total Experience of our patients when they come to Hamad
General Hospital. We have worked over the past year to plan and develop ways
to respond to the comments and feedback of the community we serve. We are
listening to what our customers have to say to us. Some of the projects that
we will launch in the very near future include:
Emergency Department
Commissioning of the ER Extension will see +73 beds in the ER
Revised patient registration and triage processes to reduce waiting times;
and treatment turnaround times
New patient flow and treatment patterns to better respond to patient needs
Improved resource utilization of patient care services that will make more
services available to those patients who need these services … when they
need them
Outpatient Department
We have achieved improvement success in developing the medical records
system and are now set to implement a medical record tracking system, which
tracks files in and out of the Department, and eliminates problems of lost
files, delays in file retrieval and multiple files for the same patient
Development and introduction of an automated patient Booking & Appointment
system. This will lead to reduced waiting times and improved OPD clinic
utilization. We will be able to see more patients with same number of clinic
rooms. The work on this project will commence during Septem-ber 2007 so that
it will be operational within a six-month period.
Satellite Pharmacies will be installed in each floor in the OPD. These
pharmacy units will be closer to the clinics; and, multiple pharmacies will
reduce waiting times and improve service to the patients. This project is
expected to take one year before being operational, as construction and
reno-vations will be required.
Customer orientation and service training for our registration and
administrative staff to better respond to the needs of our patients.
Operating Room
Development and introduction of an automated OR Booking & Sche-duling
System.
This will lead to improved OR utilization that will reduce waiting times and
reduce the number of procedure cancellations.
Development of new policies and procedures that will improve process
standards.
Bed Management
Development and introduction of an automated Bed Management and Scheduling
System.
This will help us reduce the average length of stay and better coordinate
patient admissions with the OR and other diagnostic and treatment
procedures.
Development of policies and procedures to improve admission and discharges
in the hospital. The intro-duction of admission and discharge criteria will
improve bed utilization, which will allow us to admit more patients with the
same number of beds that we currently have. A study revealed that patient’s
average length of stay at hospital is currently 6.7 days. The Hospital is
striving to achieve a target of 5.5 days, as this will enable us to admit
approximately 3,000 more patients each year.
Construction project that will allow us to open about 35 additional beds in
Hamad General Hospital. These additional beds will be recovered from office
space on the wards. First stage of this project is expected to commence next
month and take about 8-to-10 months before completion.
The implementation of a Home Care Program that will allow us to send
patients home where our staff can support and treat them. This will free up
approximately 100 additional beds for the admission of acute patients. We
have actually begun implementing a program called (Case Manager Program),
where we have currently 8 qualified nurses in this role. This is twice as
many Case Managers than last year. The program ensures better and more
prompt care to the patient; and enables us to safely discharge the patient
home in a shorter period of time. Social Workers, whose number will also be
increased, are working in coordination with Case Managers to address patient
and family needs.
